After Christopher Reeve: The Medical Promise and the Political Minefields.
In this razor-thin election, the arcane subject of embryonic-stem-cell research has rallied lawmakers, scientists, patients, celebrities-and the candidates. The issue may cause some voters to swing.

October 25, 2004

BY CLAUDIA KALB AND DEBRA ROSENBERG

231T-082-002
Dana and Christopher Reeve, 1999

Stem cells may not have been the highlight of last week’s presidential debate, but there in the front row, wedged between Teresa Heinz Kerry and Kerry’s daughter Vanessa, sat a person who stands for the power of science better than words ever could: Michael J. Fox, Diagnosed with Parkinson’s in 1991 and visibly ailing, Fox is a staunch supporter of stem-cell research and has, in recent weeks, become Sen. John Kerry’s ambassador for the cause. It didn’t bother Fox that the subject barely came up or that his presence was largely symbolic. “I’m happy I could do it. If anyone saw me there, they know that the issue is important to (Kerry),” he told Newsweek. A political junkie who watches CSpan as if it were reality TV, Fox was thrilled to have a ringside seat. He even had some fun: when Vanessa leaned over to tell Fox she was “trying to be Zen” as her father and President W. Bush went after each other on jobs, the economy and healthcare, Fox put his hands into the lotus position and said, “Om.”

Watching Fox, it was impossible not to think of Christopher Reeve, who died last week at age 52. A tireless advocate for stem-cell research –“Superman in a wheelchair,” as one friend called him- Reeve’s death refocused attention on an issue that has mobilized celebrities, activists, scientists, politicians and even regular folks who barely remember their high-school biology. Human embryonic stem cells, capable of morphing into one of the more than 200 cell types in the human body, have become a wedge issue in a razor-thin election. For months the Kerry campaign has put biology front and center, vowing to overturn Bush’s current stem-cell policy. In a radio address over the weekend, Kerry paid tribute to Reeve as a hero and friend, then charged the president with “making the wrong choice to sacrifice science for extreme right-wing ideology.” The White House has been firmly fighting back, with Laura Bush, whose father has Alzheimer’s on the front lines. “Stem-cell research doesn’t doesn’t offer a cure around the corner, and it’s irresponsible to suggest that it does,” she told a crowd in Milwaukee earlier this month. The president says his policy is a balance of science and ethics. That pleases social conservatives, who are firmly anti-abortion and adamantly opposed to research on embryos, even if they’re manufactured in a Petri dish. (According to a Newsweek poll, just over half of Bush-Cheney supporters oppose using federal tax dollars to fund embryonic-stem-cell research.) For both camps, the phrase “stem-cell” is about more than science: it’s code for some of the most loaded vernacular of the culture war.

Embryonic-stem-cell research, while still in its infancy, has the potential to treat or perhaps even cure the more than 100 million Americans who suffer an array of illnesses and conditions, from heart disease to spinal-cord injuries. Scientists say the cells could be one of the greatest revolutions in modern medicine –and half of American voters support using taxpayers dollars to fund the research, according to Newsweek poll. But because the cells are derived from days-old human embryos, the science raises thorny ethics questions, key among them: should taxpayers fund the research? As scientists and stem-cell activists push the envelope, the stakes only continue to grow. Last week Harvard researchers reported that they had applied for university permission to clone human embryos to study models of human disease like diabetes and Alzheimer's. Across the country in California, stem cells are the topic of dinner conversation and Hollywood cocktail parties, as supporters rally for votes on an initiative -on the Nov. 2 ballot- that would fund $3 billion worth of stem-cell research, creating a haven for science and a 21st-century gold rush for biologists and biotech companies.

The stem-cell issue is so divisive it has created opponents of those who would otherwise be allies. In the Reagan family, one brother, Michael, is an evangelical Christian ardently opposed to embryonic-stem-cell research; the other, Ron Jr., believes so strongly in the science he risked the wrath of his father's Republican Party by appearing at the Democratic National Convention to fire up support for research. Lesser knowns like Jim Kelly, 47 and paralyzed in a car accident seven years ago, hasn't voted since he was 18; this year he'll vote for Bush. A vocal opponent of embryonic-stem-cell research, Kelly believes the Democrats are spreading false hope among patients. Paul Bryant, meanwhile, a 56-year-old disabled by a rare neuromuscular disease and a registered independent in Cincinnati, will swing to Kerry-and he's taking 18 other family members, including his dyed-in-the-wool Republican father, George, 77, along with him. Ideology, he says, has no place in science.

Just a few miles away, in Liberty Township, Ohio, Lora Melin is the undecided voter both camps are after. A registered independent, she pulled the lever for Bush in 2000, but this year she's not so sure. The reason: her daughter, Maggie, 4, suffers from juvenile diabetes. Ten to 15 times a day, Maggie's blood sugar must be checked. And the little blond ballerina has to wear a portable insulin pump, which delivers insulin through a tube inserted into her abdomen or lower back. She carries the device to preschool in a fanny pack decorated with yellow and green ladybugs. "I wake up every morning and wonder if she's alive," says Melin. "We need the funds and we need the research.”

For months John Kerry has been putting the heat on the stem-cell issue. On June 21, the very day 48 Nobel Prize-winning scientists endorsed the candidate, Kerry appeared at a rally in Denver, where he was introduced by Chris Chappell, 40, a registered Republican-and a quadriplegic advocating for stem-cell research. Thousands turned out in a drizzle to hear Kerry pledge to advance embryonic-stem-cell research. "What if we could cure cancer, Parkinson's, AIDS and Alzheimer's?" he said. Early on, Kerry aides thought stem cells would be too arcane an issue, but they discovered they were wrong: from Seattle to Appleton, Wis., the stem-cell lingo has triggered huge applause, as much as-sometimes more than-the topic of Iraq.

Since the Democratic National Convention in July, when Kerry branded embryonic stem cells with his political monogram, the campaign has compiled a database of 2,000 people who promise to make lots of noise about stem cells in their communities. In Pennsylvania, Richard Arvdon, whose daughter has juvenile diabetes, calls constituents who are sick or who have ailing family members and asks them, "Do you realize what the implication of the election is?" Even scientists are getting political: a group called Scientists and Engineers for Change, many of them Nobelists, are traveling to swing states to educate voters on issues from climate control to, yes, stem-cell research.

The furor over stem cells started soon after President Bush's August 2001 decision to restrict federal funding to embryonic-stem-cell lines that had already been created. A registry was set up at the National Institutes of Health, and the clusters of cells, derived from frozen embryos that would otherwise be discarded by fertility clinics, could be shipped, for about $5,000, to scientists who wanted to study them. Initially the decision was viewed as a compromise, acceptable even to some scientists. But it soon became clear that the majority of the 78 lines touted by the government were unavailable (graphic); the final tally, says the NIH, is closer to 23. The lines also lack genetic diversity, and because they were grown in mouse "feeders" or cultures, they carry a risk of viral contamination. Scientists have angrily complained that their hands are tied; sick patients and groups like the Coalition for the Advancement of Medical Research have knocked down doors on Capitol Hill; celebrities have testified on behalf of the science, and legislators on both sides of the aisle have called on the president to relax his restrictions. "There is no greater way to promote life than to find a way to defeat death and disease,” says pro-life Republican Sen. Orrin Hatch. "Stem-cell research may provide a way to do that."

Bush has stayed firm and in recent weeks his campaign has been on the attack. The day Kerry appeared with Michael J. Fox at a town-hall meeting on stem cells in New Hampshire, the Bush team released a memo titled "Embryonic Stem Cell Misinformation," lambasting Kerry's use of the word "ban," when Bush's policy has actually provided more than $35 million for embryonic-stem-cell research so far. Just last week the campaign sent its favorite doctor, Sen. Bill Frist, into battle. Frist attacked a statement made by vice presidential candidate John Edwards ("If we do the work that we can do in this country ... people like Christopher Reeve are going to walk, get up out of that wheelchair and walk again") as "crass" and "opportunistic." The promise of stem cells is hyped, he added. The Bush camp emphasizes that the president supports the research, as long as no more embryos are destroyed. "The government of the United States cannot just worship at the altar of science,” says one White House aide. "We have other things to take into account.”

Not a single person has yet been cured by embryonic stem cells, but the early science is tantalizing. If you're a rat with an animal variety of Parkinson's, embryonic mouse stem cells might help: after injecting these cells into rat brains, researchers at the NIH in 2002 found that they began to produce dopamine-the key neurotransmitter missing in Parkinson's patients. At the University of California Reeve-Irvine Research Center, Hans Keirstead is helping rats with spinal-cord injuries. Keirstead will report at a scientific conference next week that he coaxed human embryonic stem cells into highly purified brain cells called oligodendrocytes, then injected them into rodents with bruised spines. After nine weeks the rats regained their ability to walk and run. The results are both "thrilling and humbling,” says Keirstead. "The humbling part is that the cells are so incredibly powerful."

Bush's policy limits the use of federal funds to create new embryonic lines, but it doesn't bar scientists from using private money. Already, that support is paying off. In March, Harvard researcher Doug Melton announced the creation of 17 new lines of cells from IVF embryos, almost doubling the NIH stockpile. His money came not from the government, but from Harvard, the juvenile Diabetes Research Foundation and the Howard Hughes Medical Institute. Now he wants to create more lines through therapeutic cloning to study genetic diseases. At the University of California, San Francisco, Dr. Susan Fisher says she's created human embryonic stem cells from human, rather than mouse, feeders-eliminating contamination concerns and taking scientists closer to clinical trials in people. Fisher's finding? A joint $800,000 investment from the University of California and the biotech company Geron.

Fisher and other scientists say the infusion of private money is indispensable, but it will never fill the gaps in funding created by the
Bush restrictions. Relying on private money is "like saying we could open the public schools from 10 to 1O5, but you're welcome to send your kids to private schools," says Nobel Prize winner Dr. Peter Agre, of Johns Hopkins. If the president is truly worried about the ethics implications of embryonic-stem-cell research, these scientists wonder, wouldn't he want to keep it under the watchful eye of federal oversight and peer review? (The private sector can and should keep tabs on research, responds NIH director Dr. Elias Zerhouni.) Without more federal money, stem-cell scientists worry further that they'll lose some of the brightest young minds to less controversial fields of research-and that their most accomplished colleagues will follow others overseas.

Some stem-cell scientists may decide to go West. On Election Day, California residents will vote on Proposition 71, by far the boldest and most ambitious endorsement of stem-cell research in the nation. Designed to sidestep Bush's funding restrictions, the initiative was organized by California real-estate mogul Robert Klein and a glittering bipartisan coalition of Hollywood and Silicon Valley activists. On the lineup: producers Doug Wick and Jerry Zucker, Bill Gates and eBay founder Pierre Omidyar. If Prop 71 passes (latest polls say 45 percent of voters favor it, 39 percent are opposed), it would provide $3 billion in state taxpayer money for research on any kind of stem cell, be it embryonic or the far less controversial-and, scientists argue, less malleable-adult stem cell. The $3 billion fund easily dwarfs even the $100 million pledged by Kerry.

At the heart of the stem-cell furor is the most fundamental question: what is a human life and when does life begin? Even Roman Catholics like Frank Cocozzelli, who has muscular dystrophy and is founder of the Committee for the Advancement of Stem Cell Research, says embryos that would otherwise be discarded should be salvaged for life: "There's no dignity in watching people die unnecessarily." Mary Tyler Moore, a prolife Republican and international chair of the juvenile Diabetes Research Foundation, equates using leftover embryos for research to organ donation. Chris Chappell frames the dilemma in a simple way: "For me, an embryo is not a human embryo until it's placed in a woman's womb. That's when it has the potential to become life." This year Chappell will vote Democratic for the first time.

For religious hard-liners-the base Bush dares not alienate-it's a black-and-white issue. There is no justification for tampering with embryos. Ever. And now, with news that Harvard scientists want to pursue therapeutic cloning, the alarm bells-and fears of "human embryo farms !"-are sounding louder. Although scientists draw a line between therapeutic cloning for research and cloning of human beings, which they expressly oppose, that distinction is irrelevant to Richard Doerilinger, of the U.S. Conference of Catholic Bishops. "There are elements to this agenda that make it even more serious than abortion,” says Doerflinger. "You have the prospect of creating lives just to destroy them.” Bishops can't endorse candidates from the pulpit, but the Conference has produced a booklet, circulated to thousands of parishes, that outlines the church's position on embryonic research.

Kerry supports therapeutic cloning; Bush opposes it. If elected, Kerry would lift restrictions on federal funding for embryonic-stem-cell research. White House aides say Bush has no plans to change his stand. Heather Bace, whose 2-year-old son has juvenile diabetes, doesn't know what to do. "I've always been a staunch conservative Republican, but I'm undecided because of this issue,” says Bace. "I would give my arms, legs and my brain to get this kid healthy. If Kerry can make it happen a little bit faster, I may just be persuaded.” Once inside the voting booth, Bace will be alone with her political loyalty and her love for her child. As the election draws near, both candidates know they're fighting for a piece of her heart.